The Most Rev. José H. Gomez, S.T.D. Archbishop of San Antonio Converging Roads Seminar
CHRISTUS Santa Rosa Hospital, San Antonio, Texas
Thank you for your warm welcome and this opportunity to talk to you.
We are here tonight to talk about health care reform, ethics, and Catholic teaching. Those are big issues. But I think it's important to remember first, why we're here as Catholics. We're here because Jesus Christ chose to come among us "healing every disease and every infirmity among people," as the Gospel of Matthew says (Matt. 4:23).
The Catholic mission in health care is a continuation of the healing ministry of Christ. When we talk about ethics and health care policy, our goal is to ensure that all medical institutions in our society remain places of healing in which the dignity, and the mystery of the human person is respected-as it was respected by Christ.
I want to start our time together by telling you about a story I heard earlier this year. It was about IBM's plans to build a new data processing center in Dubuque, Iowa. National Public Radio reported that people were excited because this new plant would bring more than a thousand new jobs to an economically distressed region ("Morning Edition," Feb. 2, 2009).
NPR interviewed a consultant who was an expert on corporate labor strategies. The reporter asked the logical question: Did this new IBM plant represent a trend of companies deciding to locate again in the United States instead of places like India or China or Mexico?
The consultant's answer surprised me. She said the real issue had very little to do with things like minimum wage, labor and benefit packages, or tax incentives offered to the corporations. The real issue, she said, was "population trends and demographics."
The competitive disadvantage for America, she said, is that we have an "older population," while places like India and Mexico have a much lower median age and a much larger pool of young workers for companies to tap into. Later I was able to verify this: the median age in America is about 37 years old; the median age in India is about 25. In some countries, the median age is below 20.
Now, what does this have to do with health care? Actually, quite a lot. But it will take me a few minutes to explain.
Demographics and population trends are a hidden factor in a lot of the issues that America faces today. Jobs, the economy, immigration, and health care are among them.
My point is that Catholic teaching and ethical decision-making never take place in a vacuum. Today, we are trying to form consciences in a health care environment that's rapidly changing.
This new environment demands fresh thinking and new approaches. Not to compromise or water-down our teaching. We need to find new ways and even a new vocabulary to articulate our teaching in this changed environment.
The Catholic Church has the oldest, most comprehensive, and most coherent and integral body of teaching on health care, bioethics, and medical issues. Our teaching is reasoned, compassionate, and practical, having developed out of more than 2,000 years of pastoral experience. Historically, the Catholic Church founded the first hospitals, not to mention the first charitable institutions.
My friends, we must refuse to allow ourselves to be forced into silence or marginalized in this debate. Long before the American revolution, Ursuline nuns were providing health care services in what is now New Orleans. Some of the great figures in American Church history-such as Rose Hawthorne Lathrop, Mother Angeline Teresa McCrory, and Marianne Cope-were pioneers and innovators in the care of the sick. Our Catholic health care networks serve millions of Americans, and are a vital part of the well-being of communities around the country.
In 1869, three Sisters of Charity of the Incarnate Word built Santa Rosa Infirmary, from the ashes of a burned building. Nurtured by the grace of God and the commitment of those who would follow them, we have seen that modest 9-bed facility grow into one of the finest hospital systems in the United States.
This is just an example of the Church's longstanding commitment to excellence in caring for the sick throughout our history. Today the Catholic Church operates more than 600 hospitals in all 50 states. In 20 of those states, they account for more than 20% of all admissions.
The Church has earned its place at the table in this debate. And the U.S. bishops have outlined several principles that we believe are essential to any authentic reform legislation:
First, health care must be regarded as a fundamental right and not a privilege. Second, policy must respect and protect human life and dignity from conception to natural death. Third, because health care is a basic human right, policy must give priority to meeting the needs of the poor and the immigrants in our midst.
Finally, in structuring new health-care delivery models, the nation must preserve a pluralism of options, respect freedom of conscience, and must restrain costs and spread their burden across the spectrum of players.
Now, my friends, the bishops are not lobbyists or politicians. Our task in social policy is to help to form the conscience of the laity. It is the laity who have the primary responsibility for bringing the values of the Gospel to the political order.
But we face another great challenge in trying to do that-the increasing secularization of American public life. The gatekeepers of our culture-in the media, politics, and the intellectual classes-are openly hostile to religion and religious values. This is especially true in health care.
A perfect example is the outcry this summer when the President appointed a Christian, Dr. Francis Collins, to head the National Institutes of Health. The headline in the New York Times (June 9) was: "Pick to Lead Health Agency Draws Praise and Some Concern." The "concern" was what the article called his "very public embrace of religion." And in the days and weeks that followed, there was a lot of talk in the press about how Dr. Collins' religious "bias" might influence his decisions on issues like stem-cell research.
This is a bald effort to stifle religious expression and viewpoints. The message is that religion is ok so long as it stays private, so long as it doesn't influence our thinking on political and social issues.
As Catholics, we can't live that way. We can't divorce our religious beliefs from our public convictions. Our challenge is to advance the Gospel and the teachings of Christ in a ways that are understood to promote the authentic human good in our civil laws and public polices.
How do we do that? I believe we need to be more creative in articulating our teaching in terms of reason and the natural law. The truth is that our teaching is not a sectarian intolerance. Catholic social teaching reflects what our Declaration of Independence calls "the laws of nature's God."
Lactantius, a Christian philosopher from the early fourth century, wrote these profound words: "For it was God who placed us in this abode of the flesh. It was he who gave us the temporary habitation of the body. That we should inhabit it as long as he pleased. Therefore, it is to be considered impious to wish to depart from it without the command of God. Therefore, violence must not be applied to nature" (The Epitome of the Divine Institutes, Chap. 39).
Now, it is up to the lay faithful-in politics, business, the media, the insurance and health care fields-to fill in the technical details of these arguments and to draw the necessary conclusions.
We need to gain a new hearing for the Church's teaching by finding new ways to present that teaching on the basis of reason, the natural law, and practical public policy considerations.
We need to find new ways to proclaim our teaching in a society that increasingly seems to have lost its foundation, a society that often seems to act against its own good and the well-being of its people.
We need to do that by promoting the Gospel as an integral way of life and a true and attractive answer to our social questions and problems.
Before I leave you, I want to say a few words about end-of-life issues. I'm very worried about the direction of this aspect of the health care debate.
I remember reading some years ago an editorial in the New York Times, in which the editors lectured us that "true respect for life includes recognizing … when it ceases to be meaningful."
It frightens me to think how often that thought has been repeated in the current health care debate-even by some of the highest political figures in our country.
The issue, of course is, who gets to decide when a life is meaningful? The government? The New York Times? What criteria or standards are we going to use to decide if a life is worth living? Are these standards going to be purely economic or based on a person's age? Who gets to draw up those standards? And what if the individual disagrees with the findings of the authorities that draw up those standards?
My brothers and sisters, as disciples of Christ, the Author of Life, we need to be at the center of these discussions. We cannot let this debate be framed solely on the basis of economic and bureaucratic interests.
No matter what any politician promises, my friends, the demographic issues we've been discussing tonight will only intensify the pressures to ration care to the old and the terminally ill. If we are not vigilant, we will wind up with country where euthanasia becomes as routine as abortion.
The great truth that we must proclaim as Catholics is that life is not simply biological. Our life is also theological. Our life is conceived and lived in dialogue, in a relationship with God.
That relationship begins before we are conceived in the womb. "Before I formed you in the womb, I knew you," God told us through the prophets (Jer. 1:5). He chose to know us and to cherish us as his sons and daughters from "before the foundation of the world," St. Paul says (Eph. 1:4).
This dialogue with God, this relationship, is not interrupted by illness, disability, or disease. Suffering and sickness can never diminish the dignity of our lives, the great mystery of our lives in the plan of God.
This is the great truth that we must communicate in the debates over health care reform. Let's recommit ourselves tonight to this noble task.
As I wrote in my book "A Will to Live: Clear Answers on End of Life Issues, "Building such a culture not only requires the collaboration of society's leaders, but it is also a duty and right of all Christians. A father or mother contributes to the culture of life by educating their children about the value of life as a gift from God; a priest contributes by defending and preaching about the value of life; a young person can help to build the culture of life by announcing the Gospel of Life to his friends and companions without letting himself be overcome by fear.
And may Our Lady of Guadalupe, the help of the sick, intercede for us, that we may be people of life bringing the Gospel of life to our nation.
Thank you for your attention tonight.